Multimorbidity patterns, sociodemographic characteristics, and mortality: Data science insights from low-resource settings

Bazo-Alvarez J.C.; Del Castillo D.; Piza L.; Bernabé-Ortiz A.; Carrillo-Larco R.M.; Smeeth L.; Gilman R.H.; Checkley W.; Miranda J.J. · American Journal of Epidemiology (2026) · DOI: 10.1093/aje/kwae466

Resumen

Multimorbidity data typically are analyzed by tallying disease counts, an approach that overlooks nuanced relationships among conditions. We identified clusters of multimorbidity and subpopulations with varying risks and examined their association with all-cause mortality using a data-driven approach. We analyzed 8-year follow-up data of people aged 35 years or older who were part of the CRONICAS Cohort Study, a multisite cohort from Peru. First, we used Partitioning Around Medoids and multidimensional scaling to identify multimorbidity clusters. We then estimated the association between multimorbidity clusters and all-cause mortality. Second, we identified subpopulations using finite mixture modeling. Our analysis revealed three clusters of chronic conditions: respiratory (cluster 1: bronchitis, chronic obstructive pulmonary disease, and asthma); lifestyle, hypertension, depression, and diabetes (cluster 2); and circulatory (cluster 3: heart disease, stroke, and peripheral artery disease). Although only the cluster comprising circulatory diseases showed a significant association with all-cause mortality in the overall population, we identified two latent subpopulations (named I and II) exhibiting differential mortality risks associated with specific multimorbidity clusters. These findings underscore the importance of considering multimorbidity clusters and sociodemographic characteristics in understanding mortality risks. They also highlight the need for tailored interventions to address the unique needs of different subpopulations living with multimorbidity to reduce mortality risks effectively. © The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

Instituciones: Universidad Peruana Cayetano Heredia